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VA Disability Claims: 5 Game-Changing Precedential Decisions You Need to Know
Tbird posted a record in VA Claims and Benefits Information,
These decisions have made a big impact on how VA disability claims are handled, giving veterans more chances to get benefits and clearing up important issues.
Service Connection
Frost v. Shulkin (2017)
This case established that for secondary service connection claims, the primary service-connected disability does not need to be service-connected or diagnosed at the time the secondary condition is incurred 1. This allows veterans to potentially receive secondary service connection for conditions that developed before their primary condition was officially service-connected.
Saunders v. Wilkie (2018)
The Federal Circuit ruled that pain alone, without an accompanying diagnosed condition, can constitute a disability for VA compensation purposes if it results in functional impairment 1. This overturned previous precedent that required an underlying pathology for pain to be considered a disability.
Effective Dates
Martinez v. McDonough (2023)
This case dealt with the denial of an earlier effective date for a total disability rating based on individual unemployability (TDIU) 2. It addressed issues around the validity of appeal withdrawals and the consideration of cognitive impairment in such decisions.
Rating Issues
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Tbird, -
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Are all military medical records on file at the VA?
RichardZ posted a topic in How to's on filing a Claim,
I met with a VSO today at my VA Hospital who was very knowledgeable and very helpful. We decided I should submit a few new claims which we did. He told me that he didn't need copies of my military records that showed my sick call notations related to any of the claims. He said that the VA now has entire military medical record on file and would find the record(s) in their own file. It seemed odd to me as my service dates back to 1981 and spans 34 years through my retirement in 2015. It sure seemed to make more sense for me to give him copies of my military medical record pages that document the injuries as I'd already had them with me. He didn't want my copies. Anyone have any information on this. Much thanks in advance.-
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RichardZ, -
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Caluza Triangle defines what is necessary for service connection
Tbird posted a record in VA Claims and Benefits Information,
Caluza Triangle – Caluza vs Brown defined what is necessary for service connection. See COVA– CALUZA V. BROWN–TOTAL RECALL
This has to be MEDICALLY Documented in your records:
Current Diagnosis. (No diagnosis, no Service Connection.)
In-Service Event or Aggravation.
Nexus (link- cause and effect- connection) or Doctor’s Statement close to: “The Veteran’s (current diagnosis) is at least as likely due to x Event in military service”-
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Tbird, -
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Post in ICD Codes and SCT CODES?WHAT THEY MEAN?
Timothy cawthorn posted an answer to a question,
Do the sct codes help or hurt my disability ratingPicked By
yellowrose, -
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Post in Chevron Deference overruled by Supreme Court
broncovet posted a post in a topic,
VA has gotten away with (mis) interpreting their ambigious, , vague regulations, then enforcing them willy nilly never in Veterans favor.
They justify all this to congress by calling themselves a "pro claimant Veteran friendly organization" who grants the benefit of the doubt to Veterans.
This is not true,
Proof:
About 80-90 percent of Veterans are initially denied by VA, pushing us into a massive backlog of appeals, or worse, sending impoverished Veterans "to the homeless streets" because when they cant work, they can not keep their home. I was one of those Veterans who they denied for a bogus reason: "Its been too long since military service". This is bogus because its not one of the criteria for service connection, but simply made up by VA. And, I was a homeless Vet, albeit a short time, mostly due to the kindness of strangers and friends.
Hadit would not be necessary if, indeed, VA gave Veterans the benefit of the doubt, and processed our claims efficiently and paid us promptly. The VA is broken.
A huge percentage (nearly 100 percent) of Veterans who do get 100 percent, do so only after lengthy appeals. I have answered questions for thousands of Veterans, and can only name ONE person who got their benefits correct on the first Regional Office decision. All of the rest of us pretty much had lengthy frustrating appeals, mostly having to appeal multiple multiple times like I did.
I wish I know how VA gets away with lying to congress about how "VA is a claimant friendly system, where the Veteran is given the benefit of the doubt". Then how come so many Veterans are homeless, and how come 22 Veterans take their life each day? Va likes to blame the Veterans, not their system.Picked By
Lemuel, -
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Question
mrmark1999
I was scheduled a c&p exam at a different office then the last c&p exam . The new office was over an hour a way I called and asked why they changed the location I was told it was in the region I am in. I asked if it could be changed to my local office the c&p coordinator said it would not be a problem. I asked if the appointment was canceled and he said yes and he will send it to the correct office for a appointment. . Now I have just received a statement of case saying i have been denied because i did not report to the original c&p exam.
1 I am not sure what can be done
2 I understand i must file an appeal with the BVA on form 9 (not sure what to check on #8 a,b,c,d on BVA hearing)
3 I am lost in what I can do.
4 can i still get an exam?
in the SOC it says
REASONS AND BASES:
We received your NOD and in additional evidence in support ofyour claim . this additional evidence indicated a current diagnosis of bilateral Acheilles tendononitis there for , a VA examination and opinion was scheduled for you to comply with the VA's Duty to Assist , you were notified of this appointment and the importance of attending this appointment .Youlive in Pickerington, Ohio and the VAMC Chillicothe is yourjurisdiction . you didnotreport to this examanation because you did not want to go to the VAMC Chillicothie. This cancellation reason is not considered "good cause".Examples of good cause include, but are not limited to the illness or hospitalization of the claimant ,death of an immeadate family member ,etc.
You were denied service connection for bilateral Acheilles tendononitis in the ratin desison dated december 3, 2009 because although there was evidence of this disability in service , we did not have current diagnosis of this disability."
it is not enough , for a grant of service connection that a disability has been sustained in service. in addition there must be residual disability attributable thereto. Your service treatment records show that you were diagnosed with bilateral Acheilles tendononitisn Augest 21,1995. These same records donot show evidence of a chronic disability. Tofulfill the requirements for chronicity, the claimed illness must have persisted for a period of 6 months. the 6 month period of chronicity is measured from the earliest date on witch all pertinent evidence establishes that the signs or symptoms of the disability first became manifest. at this time we do not have contemporaneous or objective evidence of a continuity of symptomatology since your discharge from the military. the first evidence we have that you have a diagnosis of bilateral Acheilles tendononitis is Augest 26,2010 from ABC podiatry. this is approximately 15 years post discharge from the military.
Regulations state when a claimant fails to report for an examination scheduled in conjunction with an original compensation clam ,the claim shall be rated based on the evidence of record. When the examination was schedule in conjunction with any other original claim, a reopened claim for benefit that was previously disallowed , or a claim for increase the claim shall be denied . You did not report to your Va examination : therefore ,your Claim for service connection for bilateral Acheilles tendononitis cannot be established and remains denied ."
Thank you
for any assistance in ether writing my appeal or figuring out what to do
Mark
Edited by mrmark1999Link to comment
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